Revising the doctor-patient relationship is a very important conversation. It is worthwhile and instructive to first look at how the media – broadcast, print, and web sources – participate in and affect this relationship. Stating the obvious, there are good media and bad media. Mostly bad. The power and necessity of the 24-hour news churn forces all broadcast news stations to put out all kinds of junk. The most sensational stories attract the most eyeballs. The news cycle affects newspapers as well.

The prime exception to this race to the bottom is The New York Times. Not that everything the Times prints is the unvarnished, untainted truth. But the Times does intend to provide the news. The Times is not tabloid journalism, as almost everything else seems to be.

Articles in The New York Times on science in general and medicine in particular are uniformly excellent and written with as much objectivity as possible. But the vast majority of media outlets focus on what sells, i.e., the worst aspects of human behavior. Whatever can be construed as bad and wrong becomes the hot news of the moment.

The media intentionally – or out of ignorance – distorts scientific information. Overall the media has no conception of the process of science. Media needs blacks and whites. Science and medicine are neither of these. So, probably more than 90% of the “news” people receive on medical issues is tainted, distorted, and inaccurate.

People need to participate in medical decision-making. In today’s medical environment, it is shocking and appalling how much responsibility the patient’s family needs to take on in making critical decisions. What’s called for ongoingly, now, is a doctor-patient partnership. But patients and their families are poorly equipped to be partners with their doctors, owing to the very poor quality of medical and scientific information they receive from their media sources.

Physicians’ recommendations need to be questioned closely. Overall, physicians’ expertise has deteriorated significantly in the last 20 years. There is much too much fragmentation, too much taking-for-granted of benefits of high-tech procedures, and too much promotion of pharmaceuticals.

Of course, there are many more issues. But physicians with less than 20 years of experience – and that is most of them, now – are in a box. They have as much stress as do their patients.

So, patients and their families need to be smart health care consumers. The very important question is how to become an educated advocate. Many problems arise owing to peoples’ naive approach when they interact with medicine. Their knowledge base is pathetically poor. This is partly due to the ongoing deterioration of our educational system and partly due to the ongoing deterioration of the quality of the media.

We’ve reached a crossroads in our society where many Americans are just plain ignorant. They don’t need to be, of course, but the “dumb and dumber” mode has much attraction. When people haven’t exercised their brains in a long time, the place to start is not in a medical decision-making process. But shared decision-making by the patient, the family, and the doctor is now a critical necessity. Americans need to find ways to gain access to real information and educate themselves on the important issues of health and health care.